Osteoporosis Treatment

Ibandronate (Boniva)

Ibandronate is approved for the prevention and treatment of postmenopausal osteoporosis. Taken as a once-a-month pill, ibandronate should be taken on the same day each month. Ibandronate reduces bone loss, increases bone density, and reduces the risk of spine fractures.

Reclast is approved for the treatment of Paget's disease of the bone. It is also approved as a once-yearly treatment for osteoporosis in men and postmenopausal women, or for the treatment or prevention of osteoporosis due to glucocorticoid steroid medications (such as prednisone).

Recently, Reclast was also approved for preventing osteoporosis in postmenopausal women, given as a single dose once every two years.

Calcitonin (Miacalcin, Fortical)

Calcitonin is a naturally occurring hormone involved in calcium regulation and bone metabolism. Calcitonin can be injected or taken as a nasal spray. In women who are at least five years beyond menopause, it slows bone loss and increases spinal bone density. Women report that it also eases pain associated with bone fractures.

Raloxifene (Evista)

This drug is a selective estrogen receptor modulator (SERM) that has many estrogen-like properties. It is approved for osteoporosis treatment and prevention, and can prevent bone loss at the spine, hip, and other areas of the body. Studies have shown that it can decrease the rate of vertebral fractures by 30 percent to 50 percent.

Estrogen Therapy (ET) or Hormone Therapy (HT)

These drugs, which have been used to treat the symptoms of menopause, also are used to prevent bone loss. However, recent studies suggest that this might not be a good option for many women. The U.S. Food and Drug Administration (FDA) has made the following recommendations for taking ET and HT:

Take the lowest possible doses of ET or HT for the shortest period of time to manage symptoms of menopause

Talk with your doctor about using other osteoporosis medications instead.

Parathyroid Hormone or Teriparatide (Forteo)

Forteo is approved for treating osteoporosis in postmenopausal women and for men who are at high risk for a fracture. It helps new bone to form and increases bone density. In postmenopausal women, it has been shown to reduce fractures in the spine, hip, foot, ribs, and wrist. In men, it can reduce fractures in the spine. It can be taken as a daily injection for up to 24 months.

Denosumab (Prolia)

Denosumab is the first medication in its class. It is approved for use in postmenopausal women who are at a high risk for fractures (broken bones) and in people who have tried and failed other osteoporosis treatments without success (or are intolerant of such treatments). Prolia is given as an injection just under the skin (a subcutaneous injection) twice a year.

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